Starting the Season Off on the Right Foot

With the coming of better weather, many of you will be awakening from winter hibernation and increasing your activity levels. For some, that may mean working in the yard or garden; participating in recreational sports such as jogging, baseball or softball; or simply walking through the neighborhood. So this seems like a good time to revisit treatment of perhaps the most common activity-related injury – the ankle sprain.

A sprain is a ligament injury and the ligaments most at risk at the ankle joint are those on the outside of the ankle. There are ligaments on both sides of the ankle, but because the usual injury with an ankle sprain is rolling the foot inward, the stretching forces are applied more to the ligaments on the outside. If you step on the edge of a sidewalk with the inner side of your foot, or step on a large pebble, or the side of a base, or another player’s foot, your foot can roll inward and you can injure the ligaments on the outside of the ankle.

The ligament damage can range from mild microscopic tearing to more severe tearing that stretches the ligaments’ length, and, perhaps, even tearing the ligament in two. In any of these situations, there is pain followed by fairly quick swelling. It hurts to walk, and bruising – bleeding into the soft tissues from the damaged ligaments – eventually develops.

If you can’t bear any weight, see a doctor and have an x-ray done since you may have a broken bone. However, most sprains will allow weight bearing to a degree.

Remember: “RICE”: rest, ice, compression, elevation. Rest of course means cutting back your physical activity and you may need to use crutches to assist with walking. Ice should be applied intermittently (ideally 15-20 minutes each hour) to diminish pain and swelling. Compression with an elastic bandage supports the ankle and discourages swelling, as does elevating the ankle further away from the floor than the level of your heart. Less swelling means less pain.

A severe ankle sprain can cause symptoms to linger six to eight weeks or longer, but there is good data suggesting that aggressive physical therapy can cut disability time in half. Indiana allows patients access to physical therapy for 24 consecutive days without a doctor’s prescription and a good therapist can aid in minimizing swelling, encouraging early movement and weight bearing. They can also instruct you in proper rehabilitative exercises. If after a couple of sessions the therapist feels that your treatment won’t likely be completed in 24 days, they can help you with the decision to see your doctor.